RESUMEN
This retrospective study included all patients operated on for perforated duodenal ulcer at Vicente Sotto Memorial Medical Center, Department of General Surgery from January 1994 to March 1997. It was conducted to identify the factors that would significantly affect the morbidity and mortality among patients undergoing surgery for perforated duodenal ulcer, and to demonstrate the value of a risk grading system in determining the associated mortality rate of a certain risk score. Concurrent serious medical illness, preoperative hypotension (BP100mm Hg), and perforation more than 48 hours were the significant clinical parameters that increased the mortality rate. Among patients treated by definitive surgery, 89.1 per cent were free of any risk factor compared to only 40.4 per cent for patients operated by simple closure. There was a significant relationship (p0.0001) between the risk score and the mortality rate. The mortality rate increased progressively with increased risk score: 0.0 per cent with no risk factor present, 9.1 per cent with one risk factor, 38.5 per cent with two risk factors, and 100 per cent with three risk factors. These finding underscored the importance of patient selection and the feasibility of a risk grading system in guiding surgical management. (Author)